Health Care: To Reform a la Socialists Part Deux: We've Lost the First Battle, But NOT the War
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As you know if you are a regular reader at NewsBusters, we've been discussing this so-called "health care reform" issue for at least seven months, in more than 500 fact-filled and informative posts. You can find that discussion here....and if you are new to this forum topic, I'd suggest you brew a nice pot of coffee, clean your glasses, and reserve a couple of hours to get an education on a myriad of issues surrounding the great health care debate of our time.
As of Saturday, Bela Pelosi and her criminal gang have twisted enough arms and thrown enough money around (Can you say $130 million for your vote, Congressman, for your California medical school? I knew you could!) to pass this abonination of a bill, it's time for us to regroup and figure out what is next on the agenda.
As with the first forum, this is a serious subject for serious people. All are welcome, but trolls are not, nor will trollishness or thread-derailing, flaming, or name-calling be tolerated.
As a couple of starting points....What are the true outrages in this bill? (Yes, we all know it's unconstitutional). Specifics, please. Cite Section(s) and Para(s). What are the tactics we need to use now? Groups to be pressured now? Methodology? Money? Feel free to add topics...that was just a starting point.
Okay, we now begin again....let's roll!
Rewarding Hospitals to Let Old People Die? That’s the Wrong Way to Cut Government Spending
October 27, 2012 by Dan Mitchell
[...]
Somebody should ask Paul Krugman about this horrific story. Even if the occasionally overly sensational British press is exaggerating and the real story is only half as bad as these excerpts, this is a nightmare. And it definitely shows that Krugman was wrong in 2009 when he wrote that, “In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false.”
[...]
The Flaws That Will Bring Down Obama’s Health-Care Plan
Talking about unintentional consequences...
I'm surprised the CBO didn't take this into account when they published their projections. /snark
A good rebuttal (including links/references) to the President's weekly radio address yesterday, where he tries to defend taking $716 Billion from Medicare to fund ObamaCare
More Obamacare Fiction
August 25, 2012 6:25 P.M.
The following article examines the selling of health care reform based on "greedy doctors".
Gawande’s Kitchen
By Greg Scandlen
August 22, 2012Atul Gawande is a fine writer and probably a good doctor. He was a key health care advisor to the Obama administration, largely based on writing very long articles mostly for the New Yorker about the problems he sees in the current health care system.
His most notable contribution to the health care debate was a major article he wrote in June 2009, which claimed to show that physicians in McAllen Texas were systematically over treating patients to enrich themselves. This article “became required reading in the White House and Congress during the health care debate and turned McAllen into shorthand for America’s medical spending problem,” according to NPR (National Public Radio).
Gawande argued that costs in McAllen are far higher than in El Paso, a town with similar characteristics. His only explanation: for some reason physicians in McAllen are greedier than physicians elsewhere.
As it turns out, he was wrong.
This notion suited the White House reformers to a tee. Most of them figured all the problems in health care are the fault of greedy doctors and the solution is to control the docs.
[...]
Reminds me of the comment President Obama made about leg amputations costing $30,000.00 - $50,000.00. Of course, this wasn't true.
Gawande is inspired by the chain restaurant The Cheesecake Factory. Yep. That'll work in Medicine. Patient's will always have expected outcomes just like what happens when the proper recipe is used to make a cheesecake. What hubris. (Well, he is a Rhodes scholar and a Harvard grad!)
Frankly, Gawande seems like he should be hellbent for shoe leather on Six Sigma, which Newt Gingrich is an advocate. Obama probably thinks Six Sigma is the name of George Soros' Star Chamber.
Speaking of The Cheesecake Factory, anyone else like the White Chocolate Raspberry Truffle cheesecake?
I was poking around in the actual wayback machine and found this (give it a moment or two to load) ... maybe not all lost after all.
CCH has a special briefing describing the tax measures preserved by the Court’s decision along with the related guidance issued by the Treasury Department, the IRS, United States Department of Health and Human Services (HHS), and the United States Department of Labor (DOL).
And an interesting article - Liberals, why are you celebrating Obamacare?
The author argues the following are myths:
The Healthcare Myths We Must Confront
Friday, June 29, 2012Myth #1: Healthcare prices have soared in the recent past
Myth #2: The pre-ObamaCare system was ‘insurance’
Myth #3: Stopping insurance companies from charging based on pre-existing conditions is the one good part of ObamaCare
Myth #4: Healthcare costs are very high in the United States compared to socialized countries
The following statement from the article struck me as one of the main problems with Obamacare.
If we choose to subsidize a portion of the population we should do so openly, using taxation and government spending, which at least shines sunlight on the cost, not through tricky regulation that hides it.
My question: How many people can tell you how much the exchange subsidies are going to cost? I would guess not many. The CBO's March, 2011 estimate was $777 Billion for the ten year period 2012-2021 even though exchange subsidies don't start until 2014.
Note, the above March, 2011 CBO exchange cost estimates were revised downward in March, 2012 (same pdf as above), but were offset by an increase by Medicaid costs. If you read the report, the only bright spot is the CBO revised its projected increase in health insurance premiums downward by 8% from the March, 2011 report.
I happened to see the following, so to add to my comments about exchange subsidies, there's a possibility, due to the Supreme Courts ruling, that the subsidies could cost an additional $1 Trillion dollars over the next ten years.
American Action Forum Analysis Finds Supreme Court’s Ruling on Medicaid Will Add Hundreds of Billions to Cost of Affordable Care Act
Fri, 2012-06-29 09:23 Douglas Holtz-EakinThe Affordable Care Act just got more unaffordable. Many people have worried that employers would dump their workers into the subsidized exchanges. Now there is good reason for states to dump Medicaid beneficiaries there at the expense of the federal taxpayer.
How big could it be? The American Action Forum ran the numbers. Suppose that every state takes advantage of this opportunity, and that every individual who is either on Medicaid or would be eligible for the expansion actually moves to the exchanges. The federal government would save as much as $130 billion in Medicaid in 2014, but it would be on the hook for $230 billion in new insurance subsidies. The net bottom line: a $100 billion annual expansion in federal costs.
[...]
Holtz-Eakin goes on to say that not all states will take this route, but it's reasonable to say that it could be about $50 billion a year.
I agree with the last line in Holtz-Eakin's post:
Who knew the (Un)Affordable Care Act could get even more unaffordable?
Enjoyed the article save for a couple of items.
Not all medical insurance is subsidized by the government, unless you are including the waiver on monopolies given by the government or the non-portability mandated by state government(s), for instance, which may contribute to cost. Purchasing one's own insurance does not make it portable either. Each state mandates certain coverage not necessarily covered in a different state, and, each state guards their ability to scrutinize and amend an insurers ability to function in that state. This is, finally and truly, a matter of Interstate Commerce the Left so often refer to improperly.
Portability would not benefit as much as that found with life insurance. Life insurance needs to account for inflation and recalculated longevity table, for instance, while medical insurance must take into account all that plus increases in medical costs due to advancing technology, diagnoses and treatments that a $100,000 life insurance policy need not calculate into its premiums.
The UK Daily Mail published an article today about Britain's death panel called the Liverpool Care Pathway:
Top doctor's chilling claim: The NHS kills off 130,000 elderly patients every year
- Professor says doctors use 'death pathway' to euthenasia of the elderly
- Treatment on average brings a patient to death in 33 hours
- Around 29 per cent of patients that die in hospital are on controversial 'care pathway'
NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.
[...]
It can include withdrawal of treatment – including the provision of water and nourishment by tube – and on average brings a patient to death in 33 hours.
There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP.
[...]
Professor Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.
He said: ‘The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway.
‘Very likely many elderly patients who could live substantially longer are being killed by the LCP.
‘Patients are frequently put on the pathway without a proper analysis of their condition.
[...]
The LCP was developed in the North West during the 1990s and recommended to hospitals by the National Institute for Health and Clinical Excellence in 2004.
Medical criticisms of the Liverpool Care Pathway were voiced nearly three years ago.
Experts including Peter Millard, emeritus professor of geriatrics at the University of London, and Dr Peter Hargreaves, palliative care consultant at St Luke’s cancer centre in Guildford, Surrey, warned of ‘backdoor euthanasia’ and the risk that economic factors were being brought into the treatment of vulnerable patients.
[...]
A Department of Health spokesman said: ‘The Liverpool Care Pathway is not euthanasia and we do not recognise these figures. The pathway is recommended by NICE and has overwhelming support from clinicians – at home and abroad – including the Royal College of Physicians.
‘A patient’s condition is monitored at least every four hours and, if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatments best suit their new needs.’
Hmm. How many patients improve after the Liverpool Care Pathway is implemented? Show of hands on physicians expecting improvement - anybody, somebody?
In December of 2011, The Telegraph in the UK had an article featuring Professor Pucelli and the Liverpool Care Pathway:
NHS must come clean over use of 'death pathway'
A leading doctor has called for the NHS to reveal the true extent of the use of the controversial 'death pathway' after a report found up to half of families are not informed of its use.
Not only are families not consulted or even told, but they may not be able to stop the use of the Liverpool Care Pathway with their loved one.
In January 2012, American Thinker had an article about the Liverpool Care Pathway which mentioned former CMS interim head and an architect and proponent of UK Socialized Medicine Donald Berwick, MD:
Berwick is an architect of Britain's medical rationing scheme, and his patron organization, the Commonwealth Fund, has published numerous articles and papers touting the Liverpool Care Pathway as a fine model for end-of-life cost-containment. Berwick's replacement, Marilyn Tavenner, is by most accounts an ideological acolyte of Berwick's rationing mindset, promising little change in administrative direction. For those readers who doubt the applicability of British health care examples on our system, remember that ObamaCare is modeled as the next-generation improvement to Britain's NHS, and the Liverpool Care Pathway is considered by these "experts" the gold standard of end-of-life care. We ignore this reality at the peril of our very lives.
As far back as May 19, 2010, Congress was having issue with Berwick's nomination to CMS head. Senator Pat Roberts (R-Kansas) says (video at 9:20 mark) (transcript):
Finally, this is a question about the following statement by Dr. Berwick:
Most people who have serious pain do not need advanced methods; they just need the morphine and counseling that have been around for centuries.
That is an amazing statement. I know Dr. Berwick is familiar with the Liverpool Care Pathway to death that is employed in the British health care system and its reliance on morphine and counseling. He should also be aware of the growing concerns of many British doctors that this so-called pathway to death is being overused for patients who would have otherwise recovered, especially stroke patients. Is this what is being advocated for the American health care system? For Medicare patients? This certainly sounds like the ``death panels'' that became so roundly ridiculed and dismissed by ObamaCare supporters during last year's debate.
Anyone doubt Berwick would have worked his butt off to implement a domestic version of the Liverpool Care Pathway? Beuller?
And if there are any doubts what the movers and shakers in this country feel about the Liverpool Care Pathway then look no further than Palliative Medicine, a peer-reviewed scholarly journal for those dealing with end-of-life patients:
The exclamation mark is theirs. I imagine the physicians and staff that work with end-of-life patients are relieved to have a standardized algorithm, but the title begs the question of who is more relieved - the staff or the patient/family? Published back in 2007, I wonder if they still feel the same way since reports of abuse of the pathway the past three years?
In the following article, Cannon and Cohen argue that the individual mandate isn't the only unconstitutional provision in Obamacare:
IPAB, Obamacare’s Super-Legislature
The individual mandate isn’t Obamacare’s only unconstitutional provision, or even its most unconstitutional provision. That distinction belongs to the Independent Payment Advisory Board. A heretofore unreported feature of this super-legislature makes it even more authoritarian and dangerous than anyone knew.
[...]
Worse, Obamacare forbids Congress to repeal IPAB outside of a brief window in the year 2017 — and even then requires a three-fifths supermajority in both chambers plus a presidential signature. Under Obamacare, after 2017 Congress could repeal Medicare, but not the board it created to run Medicare. Congress and the states could repeal the Bill of Rights — but not IPAB.
[...]
As if all this weren’t bad enough, we discovered a heretofore unreported feature of Obamacare. According to the statute, if Congress fails to repeal IPAB during that short window in 2017, then in 2020 Congress loses any and all power to restrain these super-legislators.
[..]
I have to ask, what were they thinking?
The Left was thinking they would be the first to select IPAB members and that these first 15 deciders would further a Utopian health care system so labyrinth that future members would be unable to undo the Gordian Knot.
From Wikipedia:
IPAB is composed of fifteen members appointed by the President, subject to Senate confirmation. The Secretary of HHS, the Administrator of the Center for Medicare and Medicaid Services, and the Administrator of the Health Resources and Services Administration serve ex officio as nonvoting members.[15] In making the appointments, the President consults with the Majority Leader of the Senate concerning the appointment of three members; the Speaker of the House of Representatives concerning the appointment of three members, the Minority Leader of the Senate concerning the appointment of three members, and the Minority Leader of the House of Representatives concerning the appointment of three members.[16]
The first members appointed to the Board will be divided into three staggered classes in order to ensure that their terms do not expire simultaneously. Five will be appointed for a term of one year, five will be appointed for a term of three years, and five will be appointed for a term of six years. All subsequent appointments will be made for six years. A member may not serve more than two full consecutive terms.[17] Individuals who are directly involved in providing or managing the delivery of Medicare items and services may not constitute a majority of IPAB’s membership.
The President of the United States must establish a system for public disclosure by IPAB members of any financial and other potential conflicts of interest. As it currently stands, no IPAB member may be engaged in any other business, vocation or employment.[1]
Members will be paid at a rate described in Level III of the Executive Schedule that determines pay for senior executive branch officials. As of 2010 this is $165,300 per year.[11]
From The Washington Examiner:
"President Obama signed an executive order last year to help the FDA anticipate drug shortages while knocking Congress for failing to pass his preferred legislation on the issue. "Congress has been trying since February to do something about this," Obama said in November. "It has not yet been able to get it done . . . we can't wait."
The committee report concluded that a significant portion of the drug shortage is a problem of the Obama administration's making. "Among shuttered manufacturing lines that occurred over the previous two years, the committee’s review did not find any instances where the shutdown was associated with reports of drugs harming customers," the report says, noting a 30 percent drop in the manufacture of certain prescription drugs at the largest manufacturers in the country."
Today Obama, in direct opposition to Federal law, decrees younger illegal aliens in the country for 5 years with otherwise clean legal records can now stay legally. This is brazen amnesty incrementalism towards eventual full citizenship with voting rights plus chain migration.
Last year Obama decrees a crackdown on pharmaceutical manufacturers with resultant drug shortages that have barely made the news. Why? Not because of dangerous medications.
Why is the USPTFS continuing to downgrade specialty group's recommendations for health care surveillance such as mammograms, PSA, Pap smears, etc?
Committee Investigation Reveals Tactics and Negotiations Used to Build Obamacare
May 31, 2012WASHINGTON, DC – The House Energy and Commerce Oversight and Investigations Subcommittee, chaired by Rep. Cliff Stearns (R-FL), today released a memo and supporting documentation outlining a series of intricate policy negotiations used to craft the health care law, the full details of which have never been released to the public. The memo is part on an ongoing investigation the committee launched more than a year ago to shine light on a process that excluded both the American people and many of their elected representatives. Despite the White House’s unwillingness to make these negotiations transparent, even after the fact, the investigation has uncovered a series of emails and internal documents that paint a much clearer picture of the tools and tactics used by the Obama administration to secure a narrow, partisan victory and see PPACA signed into law.
[...]
Excerpt from the memo:
Executive Summary
The White House negotiated a deal with the Pharmaceutical Research and Manufacturers of America (PhRMA) in mid-June 2009. After attempting to secure a commitment from the industry for $100 billion in payment cuts, eventually the White House settled for approximately $80 billion in payment reductions through expanded and increased Medicaid rebates and a new health reform fee. PhRMA also had direct input into the actual legislative policies that produced the $80 billion, including the proposal for closing the Part D doughnut hole. Under the deal, “the White House and Senator Baucus agreed” that neither price controls nor a government-run Medicare Part D plan would become law, the White House would oppose price controls on dual eligible beneficiaries, and that savings from a follow-on biologics proposal would be applied to the total $80 billion commitment. White House Office of Health Reform Director Nancy-Ann DeParle told PhRMA’s chief lobbyist for negotiating the deal that the White House would oppose new drug importation policies because of “how constructive” PhRMA had been. According to PhRMA’s lobbyist, White House Deputy Chief of Staff Jim Messina told him that the “WH is working on some very explicit language on importation to kill it in health reform.” According to internal e-mails, PhRMA’s chief lobbyist believed the White House eventually cut a deal with the pharmaceutical industry during the week of June 20, 2009, because the White House had suffered a bad week politically. Despite countless promises of televised negotiations and transparent government, the White House met in private with PhRMA representatives and drug company CEOs in July 2009, “to look the other side in the eye and shake their hand on whatever deal we work out.” The White House was not above threatening PhRMA to get its way. According to PhRMA’s chief lobbyist, the White House was going to have President Obama call for rebating all of Medicare Part D, a policy PhRMA staunchly opposed, in his Weekly Radio Address unless PhRMA cut a deal with the White House to support health reform.
The IRS has issued final regulations for the Health Insurance Premium Tax Credit:
SUMMARY: This document contains final regulations relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, the Department of Defense and Full-Year Continuing Appropriations Act, 2011, and the 3% Withholding Repeal and Job Creation Act. These final regulations provide guidance to individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit, and to Exchanges that make qualified health plans available to individuals and employers.
DATES: Effective Date: These regulations are effective on May 23, 2012.[...]
Try not to doze off, especially while reading through the examples. :)
In addition to the onerous IRS regulations, It sounds like the information that's going to be requested from the Exchanges is going to be something similar to a prostate exam ... er ... I mean applying for a mortgage.
[...]
Conclusion
Subsidized coverage under the Affordable Care Act’s exchanges will be a key fulcrum on which the success of health care reform will balance in the years ahead. Exchange coverage is expected to be the second-largest projected federal outlay of the act, just behind the Medicaid expansion. As this study has demonstrated, determining the correct level of subsidies is no easy task. Implementing the Affordable Care Act will therefore require careful consideration of how income projections will affect the availability and affordability of health insurance coverage for millions of Americans.
The findings presented here demonstrate that many households could experience meaningful differences between advance and final tax credits. Adopting an eligibility determination policy that is transparent, consistent across Medicaid and the exchanges, and generous in allowing applicants to claim a change in circumstances will therefore be critical. To this end, policy makers should consider statutory and regulatory changes that further align Medicaid and the exchanges under a single income standard.
Ensuring that exchanges have access to timely wage and income data will also improve the accuracy of income projections and keep under- and overpayments of tax credits and subsidies to a minimum.
[...]
I came across the following executive summary of a report about churning.
Churning Under the ACA and State Policy Options for Mitigation
June 2012In Summary
• The “churning” of people from one source of insurance coverage to another has long occurred in public programs like Medicaid and the Children’s Health Insurance Program (CHIP), but its scope will increase greatly with the Patient Protection and Affordable Care Act’s (ACA) Medicaid expansion and new subsidies for coverage offered in health insurance exchanges.
• An estimated 29.4 million people—equal to nearly a third of the 96 million people who will qualify for either Medicaid or exchange subsidies—will change eligibility from one year to the next. Two-thirds of churning will happen when people move between Medicaid and ineligibility for all subsidies because of income above Medicaid levels and access to employer-sponsored insurance (ESI).
• Subsidy eligibility in the exchange will be particularly volatile. More people will gain or lose subsidy eligibility from year to year than will retain such eligibility.
• To lessen churning’s negative effects—including increased administrative costs, interrupted continuity of care, and coverage gaps—states could implement comprehensive initiatives that achieve two distinct objectives: lessening churning’s extent and limiting churning’s harm.
[...]
Churning Under the ACA
Churning reflects people’s movement across three categories: eligible for Medicaid, eligible for exchange subsidies, and not eligible for any insurance affordability program. The authors estimate that, unless measures are taken to reduce its scope, year-to-year churning will affect an estimated 6.9 million people who move from Medicaid to subsidized coverage in an exchange or vice versa; 19.5 million people who move between Medicaid and ineligibility for all insurance subsidy programs; and 3.0 million people who move between subsidized exchange coverage and ineligibility for all programs. In total, 29.4 million people will change eligibility status each year. This number equals 31 percent, or nearly one-third, of the estimated 96 million who will qualify for either Medicaid or exchange subsidies.
[...]
If this is the case, then I wonder if the State exhanges will be able to keep track of all that information and calculate participant subsidies accurately.
Note: The main report was prepared by the Urban Institute for the Robert Wood Johnson Foundation.
Since the IRS will already have complete command and control of your bank/checking accounts for the purpose of ensuring you pay for medical insurance one way or the other, what's the harm in more agencies having access to your financial data?
(sarcasm/off)
There will be no end to the parasitic Left burrowing into our private lives until the State has full Borg control.
(Quasi-Sarcasm/off)
To paraphrase radio talk show host Mark Levin, when will there be enough changes, enough rules for the Left. What is the endpoint for all of this? Even ObamaCare is mostly a framework with directions for unelected individuals to make determinations later. There will be no end to the intrusions and alterations.
The text ends abruptly on the last page!
This must be a serial release and I hit the cliffhanger. Seriously, I feel for the poor schmucks responsible for reading and implementing this crap for their companies.
This borders on cruel and unusual punishment. ObamaCare is evil in so many ways.
Yeah, it cuts off right where it gets exciting. {{ ^_^}}
I'm getting over a nasty viral bug, or I seriously might just force myself to read that entire thing -- if only for the sake of knowing I may have read more crap than some of our congress critters.
The following paper was linked to at the TaxProf Blog:
The author presents some good arguments (in my opinion) why hospitals shouldn't be non-profits.
Who would have guessed. /sarc
Taxing jobs out of existence
By George F. Will, Published: May 9[...]
In 2010, however, Congress, ravenous for revenue to fund Obamacare, included in the legislation a 2.3 percent tax on gross revenue — which generally amounts to about a 15 percent tax on most manufacturers’ profits — from U.S. sales of medical devices beginning in 2013. This will be piled on top of the 35 percent federal corporate tax, and state and local taxes. The 2.3 percent tax will be a $20 billion blow to an industry that employs more than 400,000, and $20 billion is almost double the industry’s annual investment in research and development.
[...]
Cook Medical is no longer planning to open a U.S. factory a year. Boston Scientific, planning for a more than $100 million charge against earnings in 2013, recently built a $35 million research and development facility in Ireland and is building a $150 million factory in China. (Capital goes where it is welcome and stays where it is well-treated.) Stryker Corp., based in Michigan, blames the tax for 1,000 layoffs. Zimmer, based in Indiana, is laying off 450 and taking a $50 million charge against earnings. Medtronic expects an annual charge against earnings of $175 million. Covidien, now based in Ireland, has cited the tax in explaining 200 layoffs and a decision to move some production to Costa Rica and Mexico.
[...]
Unsurprisingly, Sen. Scott Brown (R-Mass.) supports repeal of the tax. Surprisingly, so does his opponent, Elizabeth Warren, an impeccably liberal Obamacare enthusiast who notes that in Massachusetts the medical devices industry has 24,000 employees and accounts for 13 percent of the state’s exports. Warren is experiencing another episode of New England remorse: “When Congress taxes the sale of a specific product through an excise tax . . . it too often disproportionately impacts the small companies with the narrowest financial margins and the broadest innovative potential.”
[...]
When I read the article and saw Elizabeth Warren supports repealing the medical device tax, I was curious. On a campaign stop in Massachusetts, she said ...
Elizabeth Warren, Fair Play, and Soaking the Rich
I hear all this, oh this is class warfare, no! There is nobody in this country who got rich on his own. Nobody. You built a factory out there–good for you.
But I want to be clear. You moved your goods to market on the roads the rest of us paid for. You hired workers the rest of us paid to educate. You were safe in your factory because of police forces and fire forces that the rest of us paid for. You didn’t have to worry that marauding bands would come and seize everything at your factory.
Now look. You built a factory and it turned into something terrific or a great idea–God Bless! Keep a Big Hunk of it. But part of the underlying social contract is you take a hunk of that and pay forward for the next kid who comes along.
My question to Warren is, after your campaign pitch above, you want factories to pay a hunk of money, so why wouldn't you want Massachusetts medical device businesses to pay the additional tax. It's there to fund heatlh care reform isn't it?
Ahhhh. Because it will cost jobs. Reality bites, doesn't it.
Obama: HHS mandate prevents 'governemt meddling'
April 28, 2012President Obama suggested that his mandate that insurance companies provide free contraception is an effort to avoid "government meddling" in health care.
[...]
Isn't the HHS mandate "government meddling" in the first place?
Again, you just can't make this stuff up.
Employers and insurers have long been at the forefront of changing the model of healthcare because of their concern with economics from a self-preservation view point, and, they didn't need totalitarian government to dictate every financial decision. Insurers can afford highfalutin attorneys and bean-counters to trim plans and budgets.
However, I stopped reading when I reached the following in the third sentence - "... America's 50 million uninsured..." this sounds suspiciously like the exaggerated claims made by Leftists.
Since the author's name sounded familiar I then Googled him and found plenty of evidence of his reliable Lefty bias here on NewsBusters, the most recent yesterday, April 24th.
What patients pay: Dr. Don Berwick and Jim Capretta debate shifting health care costs
[...]
Dr. Don Berwick, former administrator of the Centers for Medicare & Medicaid, and Jim Capretta, who serviced as associate director at the White House Office of Management and Budget under President George W. Bush, took sharply different stances on what shifting costs to patients could mean during a wide-ranging debate last night hosted by the Pioneer Institute.
Berwick, now a senior fellow at the Center for American Progress, called the idea of giving patients more “skin in the game” a “vicious idea.”
[...]
Capretta and Robert Moffit of The Heritage Foundation wrote recently in a National Affairs article that the Affordable Care Act should be replaced with a plan that gives more power to states and pushes consumers to pay attention to what their health care costs.
[...]
Berwick, a fierce advocate of the Affordable Care Act, outlined a series of steps to lower costs in an article published online last month by the Journal of the American Medical Association. They include changing how doctors and hospitals behave so that they better coordinate patient care, increase transparency, and eliminate health care deemed unnecessary.
Berwick lauded a publication put out this week by nine medical specialists listing 45 procedures they said were ineffective, too costly, or did more harm than good. Their suggestions are “not trivial,” he said.
[...]
From the above:
Berwick, now a senior fellow at the Center for American Progress, called the idea of giving patients more “skin in the game” a “vicious idea.”
I remember reading a certain item in President Obama's 2013 budget that I think relates to Berwicks statement. In the Department of Health and Human Services section, on page 112:
Encourages Beneficiaries to Seek High-Value Services.
The Budget includes structural changes that will help encourage Medicare beneficiaries to seek high-value health care services. To help improve the financial stability of the Medicare program, the Budget reduces the Federal subsidy of Medicare costs for those beneficiaries who can most afford them, and also introduces a modified Part B deductible for new beneficiaries beginning in 2017. To encourage appropriate use of home health services that are not preceded by inpatient care, new beneficiaries beginning in 2017 would be responsible for a modest copayment for home health services in certain cases. Research indicates that beneficiaries with Medigap plans that provide first dollar or nearfirst dollar coverage have less incentive to consider the costs of health care services, thus raising Medicare costs and Part B premiums for all beneficiaries. The Budget applies a premium surcharge for new beneficiaries beginning in 2017 if they choose such Medigap coverage. In addition, it strengthens the Independent Payment Advisory Board to reduce long-term drivers of Medicare cost growth.
It seems that the Administration wants Medicare home health service recipients to have more "skin in the game", something Berwick says is a "vicious idea".
You can't make this stuff up.
An interesting history of RomneyCare
How Deval Patrick Gutted Romneycare's Market-Oriented Health Reforms
On a side note, will history repeat itself? From the article, the author posits why Romney lost his 1994 bid to unseat Ted Kennedy in the Senate:
Romney didn’t win that election, in large part because he had not been prepared for a withering assault from Sen. Kennedy regarding his religious beliefs and his record at Bain Capital.
That may be so, Par, but a critical point that everyone should be aware of is what Romney said beginning at ~3:26 in the video on that web page. Combined with what the article states about what Romney wanted in/for MassCare and what the Democrats overrode him on and added to MassCare, it is reasonably feasible Romney sincerely means what he has been saying all along about RomneyCare and ObamaCare. I doubt even Romney is all robot to no not let slip his true thoughts during a heated exchange such as this with Kennedy (who had nothing of worth to say during the clip).
Frankly, this article and the accompanying video give me hope Romney will work to gut ObamaCare of at least some of it's onerous measures, if not agree to repeal the whole damned thing.
I hope Romney has learned how to deal with his past better this time. Obama will have both fanatics ready to believe whatever he says as Kennedy did, but also is sharper, gaffes and all, and more slippery than the reprobate Kennedy.
Looks like the Iowa Democrats were slapped down for their rhetoric.
Jury awards Sioux City lawmaker $231,000 in defamation suit
Friday, April 6, 2012SIOUX CITY -- A jury awarded Rick Bertrand $231,000 in damages late Friday after finding that his opponent and the Democratic Party committed libel and slander in a negative television ad in their 2010 race for an Iowa Senate seat.
Bertrand, a Republican, in October 2010 filed a lawsuit in Woodbury County District Court against his Democratic opponent at the time, Rick Mullin, and the Iowa Democratic Party, claiming he was defamed by a campaign ad that claimed Bertrand "put profits ahead of children's' health."
The Iowa Democratic Party paid for the ad, which was approved by Mullin. Jurors, who deliberated for more than four hours, ordered Mullin to pay $31,000 and the Democratic Party $200,000.
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New effort by MDs to cut wasteful medical spending
Apr 4, 3:15 AM
WASHINGTON (AP) - Old checklist for doctors: order that test, write that prescription. New checklist for doctors: first ask yourself if the patient really needs it.
Nine medical societies representing nearly 375,000 physicians are challenging the widely held perception that more health care is better, releasing lists Wednesday of tests and treatments their members should no longer automatically order.
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Dr. Christine Cassel, president of the American Board of Internal Medicine, said the goal is to reduce wasteful spending without harming patients. She suggested some may benefit by avoiding known risks associated with medical tests, such as exposure to radiation.
"We all know there is overuse and waste in the system, so let's have the doctors take responsibility for that and look at the things that are overused," said Cassel. "We're doing this because we think we don't need to ration health care if we get rid of waste." Her group sets standards and oversees board certification for many medical specialties.
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It's unclear how much money would be saved if doctors followed the 45 recommendations rigorously. Probably tens of billions of dollars, and maybe hundreds of billions over time. That would help, but come nowhere near solving, the problem of high health care costs.
The nation's medical bill hit $2.6 trillion in 2010. A major quandary for cost-cutters is that most of the spending is attributable to a relatively small share of very sick people. Just 5 percent of patients accounted for half the total costs among privately insured people, according to a recent study from the IMS Institute for Healthcare Informatics.
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No. Renewed effort, maybe, but not new except for some of the recommendations for FP's. This isn't the first time thrifty medical spending has been recommended.
FP and IM share only one recommendation which concerns acute low back pain. The recommendation is years old.
Two of the FP recommendations are relatively new. Treatment algorithms for acute sinusitus vary depending on the speciality doing the recommendation, but this is the latest and the greatest. The recommendation on Pap Smears is right out of the March 2012 USPSTF recommendations, the same group that created a stir with their 2009 mammogram recommendations. I find it interesting that the AAFP jumped on this barely month old recommendation without further investigation, let alone what ACOG, ACS, and other specialty groups think. My concern is the AAFP "deciders" are overwhelmingly comprised of Socialized Medicine fanatics and Obama-loving government lapdogs eagerly following Obama and Sebielus into the abyss.
Interesting
GOP plan would open FEHBP to non-feds
3/16/2012Republicans critical of Medicare have proposed an alternative that would open up the Federal Employee Health Benefits Plan to Medicare patients.
On Thursday, Sens. Lindsey Graham (R-S.C.), Rand Paul (R-Ky.), Jim DeMint (R-S.C.) and Mike Lee (R-Utah) introduced the Congressional Health Care for Seniors Act (CHCSA), a bill to add senior citizens to the FEHBP.
"We are going to offer a plan that would give all senior citizens in the country the same congressional health care plan that we have," Paul said, during the press conference announcing the bill. "We are not willing to wait until after the next election to fix the entitlements."
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I wonder if the crowd that was calling for "Medicare for all" will now be on board with "FEHBP for all", even though it appears Federal Employee Unions are going to oppose it:
Opposition from federal groups
Federal groups have expressed concern about the bill's impact on federal employees and their benefits if it became law.
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The president of federal union National Treasury Employees Union called the proposal a "disservice to the millions currently enrolled in Medicare and the more than 8 million federal employees, retirees and their families covered under FEHBP."
The bill would "threaten the stability of FEHBP and most likely result in higher premiums from the greater risks to their health and associated costs generally incurred by an older population," said NTEU president Colleen Kelley in a statement emailed to Federal News Radio.
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The article continues with a breakdown of the bill.
What Were They Thinking at Health Affairs?
Health Affairs is a peer-reviewed journal, which is why it was surprising to see it publish a recent article on the Massachusetts health reform, by Long et al [gated, but with abstract]. Based on telephone surveys, the authors declare that RomneyCare “continued to fare well in 2010.” This is an important finding, as the authors consider RomneyCare “the template for the federal Affordable Care Act of 2010.”
Unfortunately, in several cases the authors fail to inform readers that their results are contradicted by other, possibly more reliable, sources of information. They also neglect to put some of their results in proper context. Some examples:
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The author does a fair job of rebutting the conclusions of the article published in Health Affairs.
On a side note: I've been following John Goodman's Health Policy Blog for some time now. I highly recommend it.
In a blog about a transparency provision in the ACA, the Physician Payment Sunshine provision, the president of PhRMA thinks any new CMS rules should provide appropriate context regarding payments from Pharmaceutical companies to health care providers.
Transparency should bring clarity, not confusion
I was just wondering, where was PhRMA's concern about transparency when they were negotiating a behind-the-scenes deal with the Whitehouse to protect drug makers from bearing further costs in the overhaul.
White House Affirms Deal on Drug Cost
WASHINGTON — Pressed by industry lobbyists, White House officials on Wednesday assured drug makers that the administration stood by a behind-the-scenes deal to block any Congressional effort to extract cost savings from them beyond an agreed-upon $80 billion.
Drug industry lobbyists reacted with alarm this week to a House health care overhaul measure that would allow the government to negotiate drug prices and demand additional rebates from drug manufacturers.
In response, the industry successfully demanded that the White House explicitly acknowledge for the first time that it had committed to protect drug makers from bearing further costs in the overhaul. The Obama administration had never spelled out the details of the agreement.
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I would still like to know the details of the behind-the-scene deals PhRMA made with the Whitehouse. I'll take it, along with any context PhRMA would like to provide.
If PhRMA was as concerned about transparency back then as they are now, I'd take them more seriously.
Not to worry. Closed practices means fewer expenditures on patient care resulting in savings. Earlier death of "units" means additional savings Democrats can point to in future elections: "We're the Party of fiscal responsibility!"
The Democrats hope to squeeze out private entrepreneurship and funnel physicians and patients into Government owned and run factory clinics.
I recall some people saying that the individual mandate was a conservative idea, because Heritage had proposed a plan that contained an individual mandate. The following article was an eye opener. (h/t John Goodman)
Heritage and the Individual Mandate
By Peter Ferrara on 12.21.11
WASHINGTON (AP) -- The federal government is taking on a crucial new role in the nation's health care, designing a basic benefits package for millions of privately insured Americans. A framework for the Obama administration was released Thursday.
The report by independent experts from the Institute of Medicine lays out guidelines for deciding what to include in the new "essential benefits package," how to keep it affordable for small businesses and taxpayers, and also scientifically up to date.
About 68 million Americans, many of them currently insured, ultimately would be affected by the new benefits package. That's bigger than the number of seniors enrolled in Medicare.
The advisers recommended that the package be built on mid-tier health plans currently offered by small employers, expanded to include certain services such as mental health, and squeezed into a real-world budget.
They did not spell out a list of services to cover, but they did recommend that the government require evidence of cost effectiveness.
more from the AP here and because the AP are goobers who don't know how to link their sources... unfortunately you can't get the entire report without forking over some cash.
An short Interview with John McDonough:
Why IS Health Care Reform So Elusive?
John McDonough, HSPH professor of the practice of public health, was a senior adviser on the U.S. Senate committee responsible for developing the Patient Protection and Affordable Care Act, the landmark health care reform plan that President Barack Obama signed into law in March 2010. A former Massachusetts state legislator and executive director of the advocacy group Health Care for All, McDonough recently spoke with the Review about the revolutionary law, which he compares to the Social Security Act of 1935 and the Medicare and Medicaid Act of 1965. His new book is Inside National Health Reform.
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I was curious about this comment:
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Q: How does American public opinion break down on health care reform?
A: About half of the public—mainly Republicans—says that the law should either be completely repealed or substantially repealed. About half—mainly Democrats—says the law should be kept as is or strengthened.
Q: Does that suggest Americans have different core beliefs about the issue?
A: There is a broad shared sense—actually, bipartisan—that we spend much more on health care services than we would need to if we had an efficient, effective health care system. The difference is how to do that. For example, Democrats wanted to reduce Medicare spending by $450 billion over ten years and use those proceeds to pay for expanding coverage to the uninsured. Republicans don’t mind cutting Medicare by $450 billion—but they wanted to use the money for tax cuts. It’s not an argument over facts or data. It’s an argument, fundamentally, over values.
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Republicans don't mind cutting Medicare by $450 billion, but they wanted to use the money for tax cuts? Seriously?
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This is what happens when your ideologic views don't match up with reality.
Dems facing sticker shock for Obamacare